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InAmerican Catholic Hospitals, Barbra Mann Wall chronicles changes in Catholic hospitals during the twentieth century, many of which are emblematic of trends in the American healthcare system. Wall explores the Church's struggle to safeguard its religious values. As hospital leaders reacted to increased political, economic, and societal secularization, they extended their religious principles in the areas of universal health care and adherence to the Ethical and Religious Values in Catholic Hospitals, leading to tensions between the Church, government, and society. The book also examines the power of women--as administrators, Catholic sisters wielded significant authority--as well as the gender disparity in these institutions which came to be run, for the most part, by men. Wall also situates these critical transformations within the context of the changing Church policy during the 1960s. She undertakes unprecedented analyses of the gendered politics of post-Second Vatican Council Catholic hospitals, as well as the effect of social movements on the practice of medicine.

This chapter contains sections titled: Religion and Morality are not Isomorphic or Commensurable The Durkheimian Stream: Obligation, Commitment, and Ritual Performance The Weberian Stream: Practice and Religious Values A Brief Ethnographic Invitation Conclusion Acknowledgments References

Purpose Neurofilament light (NfL) is a biomarker reflecting neurodegeneration and acute neuronal injury, and an increase is found following hypoxic brain damage. We assessed the ability of plasma NfL to predict outcome in comatose patients after out-of-hospital cardiac arrest (OHCA). We also compared plasma NfL concentrations between patients treated with two different targets of arterial carbon dioxide tension (PaCO 2 ), arterial oxygen tension (PaO 2 ), and mean arterial pressure (MAP). Methods We measured NfL concentrations in plasma obtained at intensive care unit admission and at 24, 48, and 72 h after OHCA. We assessed neurological outcome at 6 months and defined a good outcome as Cerebral Performance Category (CPC) 1–2 and poor outcome as CPC 3–5. Results Six-month outcome was good in 73/112 (65%) patients. Forty-eight hours after OHCA, the median NfL concentration was 19 (interquartile range [IQR] 11–31) pg/ml in patients with good outcome and 2343 (587–5829) pg/ml in those with poor outcome, p  < 0.001. NfL predicted poor outcome with an area under the receiver operating characteristic curve (AUROC) of 0.98 (95% confidence interval [CI] 0.97–1.00) at 24 h, 0.98 (0.97–1.00) at 48 h, and 0.98 (0.95–1.00) at 72 h. NfL concentrations were lower in the higher MAP (80–100 mmHg) group than in the lower MAP (65–75 mmHg) group at 48 h (median, 23 vs. 43 pg/ml, p  = 0.04). PaCO 2 and PaO 2 targets did not associate with NfL levels. Conclusions NfL demonstrated excellent prognostic accuracy after OHCA. Higher MAP was associated with lower NfL concentrations.

This paper proposes a systematic framework for the analysis of tensions in corporate sustainability. The framework is based on the emerging integrative view on corporate sustainability, which stresses the need for a simultaneous integration of economic, environmental and social dimensions without, a priori, emphasising one over any other. The integrative view presupposes that firms need to accept tensions in corporate sustainability and pursue different sustainability aspects simultaneously even if they seem to contradict each other. The framework proposed in this paper goes beyond the traditional triad of economic, environmental and social dimensions and argues that tensions in corporate sustainability occur between different levels, in change processes and within a temporal and spatial context. The framework provides vital groundwork for managing tensions in corporate sustainability based on paradox strategies. The paper then applies the framework to identify and characterise four selected tensions and illustrates how key approaches from the literature on strategic contradictions, tensions and paradoxes—i.e., acceptance and resolution strategies—can be used to manage these tensions. Thereby, it refines the emerging literature on the integrative view for the management of tensions in corporate sustainability. The framework also provides managers with a better understanding of tensions in corporate sustainability and enables them to embrace these tensions in their decision making.

This chapter contains sections titled: Theorizing Difference Putting Difference in Its Place: How Geographers Deal with Difference Toward a Different Difference Concluding Differences References

Background Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disorder associated with progressive loss of motor neurons, this result in muscle denervation, atrophy and consequently death takes place due to respiratory failure within 3–5 years of onset of symptoms. Our aim Was to investigate types and frequency of headache in ALS patients. Methods This is cross sectional hospital based study. Clinically definite 100 ALS Patients (diagnosed according to El Escorial revised criteria) were recruited out of 137 ALS patients presented to the Neuromuscular Clinic in Ain Shams university Hospital from February 2022 to June 2024. Patients were screened for headache types and symptoms diagnosed according to International Headache Society criteria (IHS). Headache severity and impact were assessed using Arabic versions of Headache Impact Test (HIT) and Migraine Disability Assessment (MIDAS). Depression was also assessed via Arabic version of Beck's Depression Inventory (BDI). ALS symptoms severity was assessed via Arabic version of Amyotrophic Lateral Sclerosis Functional Rating Scale Revised (ALSFRS-R). Cognitive functions were assessed via the Egyptian version of the Edinburgh Cognitive and Behavioral Amyotrophic Lateral Sclerosis Screen (ECAS ‑EG ). Demographic data and ALS related parameters were collected. Results Among 100 patients with clinically definite ALS, 79 patients reported headaches, 62 of them had primary headaches; with tension-type headache being the most commonly reported in 46 patients, Migraine in 16 patients. Fifteen ALS patients had secondary headaches; among them 12 had headache secondary to respiratory insufficiency and 3 patients developed headache after the initiation of Riluzole therapy. Two patients had non specific headache. Mean age for the patients at ALS presentation was 43.9 ± 13.8, Mean ALSFRS-R score 33.3 ± 9.04. The relationships between headache and clinical features of ALS were also investigated. In conclusion ALS patients should be evaluated for Headache; Not only headache secondary to respiratory compromise and hypercapnea, but also primary headaches which can be overlooked in patients with ALS.

The Middle East and North Africa are one of the most conflict-prone regions. Due to its geopolitical position and oil production, the Middle East has always been the trump card in the game, both before World War II and during the Cold War, still today. Why do wars persist in the Middle East? Why has the situation in the Middle East deteriorated to this extent? Is rentier economics always a vital variable explaining political instability in the Middle East? After empirically analyzing the causes of political instability in the Middle East using various data, the study suggests that the experience of being a colony of Britain, France, and Italy hurt society and that the critical geographic location between the United States and the Soviet Union during the Cold War suffered various harmful effects. On the other hand, the result also shows that manufacturing weakness due to the oil economy, high unemployment rates, and lack of democracy are all critical explanatory variables for political instability. Since the 2000s, the United States has increased its energy self-sufficiency rate through the shale oil and gas revolution. The Middle East is an option for the United States to buy oil. On the other hand, the Middle East is essential for the United States to export weapons. The Middle East has faced a geopolitical crisis in recent years due to these factors.

Through the use of qualitative analysis, this paper examines the diverse tensions that social entrepreneurs have to deal with in their daily business activity. By using paradox theory and the hybrid organization model as a framework for analysis, we have found three principle causes of tension among social entrepreneurs: social vs economic sustainability; work vs family life; and resistance to change vs innovation. The results show the way in which social entrepreneurs in hybrid organizations resolve these conflicting tensions, usually through a selective coupling strategy, which is eventually complemented with alternative approaches such as compromising or decoupling. Social entrepreneurs tend to focus on one aspect of the tension and deal with it individually, which makes it more manageable. Change and innovation are the triggers for using strategies other than selective coupling, such as compromising or decoupling. When the level of tension rises further, compromising is then used. Decoupling is the last option chosen by social entrepreneurs, and is used only in cases where resolution is not possible with the other two strategies mentioned.

Many challenges to economic and social well-being require close collaboration between business, government, and civil-society actors. In this context, the involvement of multiple companies (i.e., business partners) rather than a single company may enhance such crosssector social partnerships' (CSSPs) outcomes. However, extant literature cautions about the tensions arising from companies' competitive interests and the detrimental effects on the CSSP's social outcome. Similarly, studies analyzing simultaneous collaboration and competition (i.e., coopetition) suggest shielding off competitive elements from the collaboration. Based on insights into two multicompany CSSPs, we conversely find that government and NGO partnership managers deliberately leveraged competition through the CSSP design. They used similar segmentation mechanisms to enhance CSSP contributions, but differed in the way they integrated collaborative and competitive elements, leading to sustained corporate commitment in one CSSP and unmet promises in the other. These insights expose the paradoxical nature of coopetition at the interface of social and economic goals, and advance current research by indicating competition's positive effects and the respective partnership design implications. On this basis, our study helps reveal and better understand sustainability-related tensions and opportunities at the inter-organizational level.

China in the midst of great changes has both changed and remained unchanged. Chinese society is full of hope but also faces many challenges. In particular, there is a paradox about the hope of the Chinese people. On the one hand, most of them are confident about the great rejuvenation of the Chinese nation, on the other hand, in the face of their own personal future, they are in a gloomy mood. How to make sense of this situation? This article carries on the analysis from five aspects. First of all, it reveals the objective context for the formation of hope by showing the structural changes of Chinese society since the reform and opening up. Secondly, it discusses the evolution of Chinese people’s spiritual world around individualism and consumerism, which is related to the subjective schema of hope. Third, the Chinese Dream is viewed in terms of the supply of social meaning and the construction of a community of hope. Fourth, it analyzes the mental order from the moral deficiency and structural tension in Chinese society. Finally, it examines the situations and hopes of the major social classes in the platform economy. Chinese culture is not bothered by paradoxes, but is used to living with them and looking for opportunities to break through them. Culturally speaking, China’s greatest hope lies in its spirit to strive for self-improvement unremittingly through intergenerational dynamics.